Drug interactions
Levofloxacin + Methadone
Severity: Major
Levofloxacin and Methadone: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs can prolong the QT interval, so combined use raises the risk of torsades de pointes. Risk is greater with high methadone doses, hypokalemia or other QT-prolonging drugs.
What this interaction means in plain words
Levofloxacin and Methadone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Levofloxacin belongs to Anti Bacterial; Methadone belongs to Musculoskeletal.
Why it happens
Additive QTc prolongation through hERG potassium channel blockade.
What to do
Consider an antibiotic with less QT effect, or obtain a baseline ECG and monitor QTc during therapy. Correct potassium and magnesium deficits.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Methadone
- Alvimopan + Methadone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Methadone Contraindicated
- Droperidol + Methadone Contraindicated
- Ibutilide + Methadone Contraindicated
- Isocarboxazid + Methadone Contraindicated
- Lefamulin + Methadone Contraindicated
Other interactions of Levofloxacin
- Dronedarone + Levofloxacin Contraindicated
- Ibutilide + Levofloxacin Contraindicated
- Levofloxacin + Thioridazine Contraindicated
- Levofloxacin + Vandetanib Contraindicated
- Levofloxacin + Ziprasidone Contraindicated
- Adagrasib + Levofloxacin Major
Frequently asked questions
Can I take Levofloxacin with Methadone?
MediHelp rates the interaction as major. Levofloxacin and Methadone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs can prolong the QT interval, so combined use raises the risk of torsades de pointes. Risk is greater with high methadone doses, hypokalemia or other QT-prolonging drugs.
How serious is the interaction between Levofloxacin and Methadone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Consider an antibiotic with less QT effect, or obtain a baseline ECG and monitor QTc during therapy. Correct potassium and magnesium deficits.
What other medicines interact with Methadone?
MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone page.
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